Individual
DR. STEPHEN DANIEL WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1305 JENNINGS MILL RD STE 110, WATKINSVILLE, GA 30677-7241
(706) 613-5880
Mailing address
3650 J DEWEY GRAY CIR, AUGUSTA, GA 30909-1867
(706) 863-9797
(706) 860-7686
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
2017-00691
NC
207X00000X
Orthopaedic Surgery Physician
Primary
79912
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1497016034
—
NC
01
—
2017-00691
MEDICAL LICENSE
NC
05
—
NC3012
—
SC
Enumeration date
05/30/2012
Last updated
07/27/2020
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